Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $56.06 / $56.65 / $68.66	Professional		$56.06	$56.65	$68.66
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.88 / $21.77 / $22.24	Professional	26	$19.88	$21.77	$22.24
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $34.40 / $36.72 / $47.83	Professional	TC	$34.40	$36.72	$47.83
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $26.93 / $26.93 / $56.19	Professional		$26.93	$26.93	$56.19
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $10.51 / $10.51 / $21.93	Professional	26	$10.51	$10.51	$21.93
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $16.42 / $16.42 / $34.26	Professional	TC	$16.42	$16.42	$34.26
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $65.31 / $73.80 / $79.54	Professional		$65.31	$73.80	$79.54
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $21.37 / $22.48 / $29.27	Professional	26	$21.37	$22.48	$29.27
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $42.83 / $48.40 / $54.26	Professional	TC	$42.83	$48.40	$54.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $27.85 / $42.92 / $124.21	Professional		$27.85	$42.92	$124.21
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.39 / $14.38 / $44.33	Professional	26	$11.39	$14.38	$44.33
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $14.90 / $28.69 / $79.23	Professional	TC	$14.90	$28.69	$79.23
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $80.28 / $104.36 / $118.70	Professional		$80.28	$104.36	$118.70
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $23.77 / $30.90 / $38.97	Professional	26	$23.77	$30.90	$38.97
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $56.51 / $73.45 / $85.78	Professional	TC	$56.51	$73.45	$85.78
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $34.00 / $56.38 / $80.00	Facility	26	$34.00	$56.38	$80.00
Medcost Facility/Professional Professional Modifier Low / Median / High Price $33.00 / $56.00 / $119.00	Professional		$33.00	$56.00	$119.00
Sentara Facility/Professional Professional Modifier Low / Median / High Price $30.68 / $65.59 / $117.99	Professional		$30.68	$65.59	$117.99
Sentara Facility/Professional Professional Modifier 26 Low / Median / High Price $23.60 / $27.23 / $44.83	Professional	26	$23.60	$27.23	$44.83
Sentara Facility/Professional Professional Modifier TC Low / Median / High Price $27.31 / $44.69 / $79.61	Professional	TC	$27.31	$44.69	$79.61
United Facility/Professional Professional Modifier Low / Median / High Price $39.47 / $69.12 / $111.44	Professional		$39.47	$69.12	$111.44
United Facility/Professional Professional Modifier 26 Low / Median / High Price $15.74 / $26.24 / $52.59	Professional	26	$15.74	$26.24	$52.59
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.16 / $39.24 / $69.28	Professional	TC	$21.16	$39.24	$69.28